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Construction, validation, and visualization of a web-based nomogram to predict overall survival in small-cell lung cancer patients with brain metastasis

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Abstract

Introduction

Brain metastasis (BM) is an aggressive complication with an extremely poor prognosis in patients with small-cell lung cancer (SCLC). A well-constructed prognostic model could help in providing timely survival consultation or optimizing treatments.

Methods

We analyzed clinical data from SCLC patients between 2000 and 2018 based on the Surveillance, Epidemiology, and End Results (SEER) database. We identified significant prognostic factors and integrated them using a multivariable Cox regression approach. Internal validation of the model was performed through a bootstrap resampling procedure. Model performance was evaluated based on the area under the curve (AUC) and calibration curve.

Results

A total of 2,454 SCLC patients' clinical data was collected from the database. It was determined that seven clinical parameters were associated with prognosis in SCLC patients with BM. A satisfactory level of discrimination was achieved by the predictive model, with 6-, 12-, and 18-month AUC values of 0.726, 0.707, and 0.737 in the training cohort; and 0.759, 0.742, and 0.744 in the validation cohort. As measured by survival rate probabilities, the calibration curve agreed well with actual observations. Furthermore, prognostic scores were found to significantly alter the survival curves of different risk groups. We then deployed the prognostic model onto a website server so that users can access it easily.

Conclusions

In this study, a nomogram and a web-based predictor were developed to predict overall survival in SCLC patients with BM. It may assist physicians in making informed clinical decisions and determining the best treatment plan for each patient.

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Data availability

The datasets generated and analyzed during the current study are available in the Surveillance, Epidemiology, and End Results (SEER) repository[https://seer.cancer.gov/data/].

Abbreviations

SCLC:

Small-cell lung cancer

BM:

Brain metastasis

AUC:

Area under the curve

SEER:

Surveillance, Epidemiology, and End Results

AJCC:

American Joint Committee on Cancer

VALSG:

Veterans Administration Lung Study Group

NCI:

National Cancer Institute

ROC:

Receiver operating characteristic

DCA:

Decision curve analysis

OS:

Overall survival

PCI:

Prophylactic cranial irradiation

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Acknowledgments

The authors thank Mrs. Yunru Fan and Dr. Alexandra Lam for coordinating and supporting the development and preparation of the manuscript.

Funding

The funding was provided by the High-level Hospital Construction Project of Maoming People's Hospital, the Medical Research Fund of Guangdong Province (#B2022278), the Research Project of Maoming Science and Technology Bureau (Grant No. 2021121), and the Outstanding Young Talents Program of Maoming People's hospital (#SY2021021). This study was supported by the High-level Hospital Construction Project of Maoming People's Hospital.

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Authors and Affiliations

  1. Department of Respiratory and Critical Care Medicine, Maoming People’s Hospital, Maoming, China

    Min Liang

  2. Department of Otolaryngology, Maoming People’s Hospital, Maoming, China

    Mafeng Chen

  3. Division of Pulmonary, Critical Care and Sleep Medicine, Marshall University, Huntington, USA

    Shantanu Singh

  4. City Hospital, Shahjahanpur, India

    Shivank Singh

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  1. Min Liang
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  2. Mafeng Chen
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  4. Shivank Singh
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Contributions

Study concepts: M.L and MF.C; Study design: M.L, Data acquisition: M.L, Data analysis and interpretation: S.S and S.S, Statistical analysis: M.L. Manuscript preparation: M.L and Shivank Singh. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Corresponding author

Correspondence to Min Liang.

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Competing interests

All authors declare that they have no competing interests.

Ethical approval

The ethics committee approved the protocol for the study at Maoming People's Hospital. All authors have signed the SEER Research Data Agreement to protect patient privacy, which aligns with ethical principles.

Research involving human/animal participants

This article was based on open-access databases and does not involve any new research with human participants or animals.

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Liang, M., Chen, M., Singh, S. et al. Construction, validation, and visualization of a web-based nomogram to predict overall survival in small-cell lung cancer patients with brain metastasis. Cancer Causes Control 35, 465–475 (2024). https://doi.org/10.1007/s10552-023-01805-9

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  • DOI: https://doi.org/10.1007/s10552-023-01805-9

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